Fisioterapia temprana, funcionalidad y complicaciones postoperatorias en adultos con cirugía abdominal de urgencia / Early physiotherapy, functionality, and postoperative complications in adults undergoing emergency abdominal surgery

Introducción Se desconoce la importancia del acceso temprano a la fisioterapia (FT) en personas sometidas a cirugía abdominal de urgencia, por lo tanto este estudio se enfocó en determinar la efectividad de la FT temprana versus tardía en la mejora de niveles funcionales y reducción de complicaciones postoperatorias (CP) en adultos sometidos a este procedimiento. Metodología Estudio retrospectivo que incluyó a 132 pacientes ingresados por cirugía abdominal de urgencia. Se registró el inicio de FT (temprana vs. tardía), se evaluó la funcionalidad mediante índice de Barthel y la puntuación acumulada de deambulación (CAS), las CP y la duración de la estancia hospitalaria. Resultados Las personas que recibieron FT temprana exhibieron CP de menor gravedad (p=0,012). Asimismo, el grupo con FT temprana tuvo estancias hospitalarias más cortas (mediana=10 vs. 17 días; p=0,0001). Adicionalmente, se observó que la funcionalidad intrahospitalaria disminuyó respecto a valores prehospitalarios (índice de Barthel y CAS), mientras que al alta se observaron incrementos parciales, sin diferencias entre los grupos que recibieron FT temprana o tardía. Sin embargo, el grupo con FT temprana requirió un menor número de sesiones de FT motora (p=0,04). Conclusión En el presente estudio el desarrollo de CP de menor gravedad, menores estancias hospitalarias y una menor necesidad de FT motora fue observada en pacientes sometidos a cirugía abdominal de urgencia que recibieron FT temprana respecto a tardía. Esto sugiere que la FT temprana en este contexto optimizaría los recursos asociados a la atención en salud, mejorando además el proceso posquirúrgico en estos pacientes (AU)

Introduction Given that the relevancy of early physiotherapy (PT) in persons undergoing emergency abdominal surgery is unknown, this study aimed to determine the effectiveness of early versus late physiotherapy in improving functional levels and reducing postoperative complications (PC) in adults undergoing this procedure. Methodology Longitudinal retrospective study which included a sample of 132 patients admitted for emergency abdominal surgery. Functionality was evaluated using the Barthel index and the cumulated ambulation score (CAS). In addition, the type of PT (early vs. late) and the date of its onset were recorded, the PC during the hospital stay and the length of stay were recorded. Results Patients that received early PT exhibited less severe postoperative complications (p=0.012). Moreover, this group had a shorter length of stay (median=10 vs. 17 days; p=0.0001). In addition, in terms of functionality, decreases were observed during hospitalization compared with baseline levels (Barthel index and CAS), whereas a partial increase was observed at discharge, without differences between the patients that received early PT or not. Nevertheless, the early PT group required a lower number of PT sessions (p=0.04). Conclusion In this study, a less severe postoperative complications rate, shorter length of stay, and lower necessity of PT sessions were observed in adults undergoing emergency abdominal surgery that received early PT versus late PT. This suggests that early PT in this context would optimize health care resources, improving the postoperative process in these patients (AU)

Tuning the conductance of carbon rings with impurities and electric fields.

We explore two mechanisms to tune the electronic conductance of carbon atom rings, namely, substitutional impurities and in-plane external electric fields. First-principles calculations and a tight-binding approach are used to model the systems. Two bond configurations are studied, cumulenic and polyynic, which can be relevant depending on the number of carbon atoms in the ring. We find that both impurity substitution and electric field mechanisms allow for modifying the electronic spectrum and transport characteristics. Interestingly, cumulenic and polyynic carbon rings present a different response to these perturbations, which can also be a way to elucidate the bond nature of these structures.

Transport signatures of few-atom carbon rings.

We study the electronic transport through an all-carbon quantum ring side-coupled to a quantum wire. We employ both first-principles calculations and a tight-binding approach; the latter allows for the derivation of analytical expressions for the conductance and density of states, which facilitates the interpretation of the transport characteristics. Two bond models are employed: either all the hoppings are equal (cumulenic ring) or they have alternating bonds (polyynic ring). Assuming cumulenic bonds, if the number of atoms in the carbon ring is a multiple of four, it produces an antiresonant peak in the conductance at the Fermi level. This effect disappears for the polyynic configuration, i.e., when the hoppings in the carbon rings are alternating. Additionally, a gap opens at the Fermi energy in the polyynic rings, yielding distinct transport signatures for the two bond configurations. Comparison to first-principles calculations shows an excellent agreement on the changes of the conductance due to the carbon ring. We propose such transport measurements as a way to elucidate the character of the bonds in these novel carbon nanostructures.

Estancia hospitalaria y funcionalidad en pacientes con retraso en el inicio de tratamiento de fisioterapia / Length of hospital stay and functional status in patients with delayed start of physical therapy

Objetivo Evaluar la asociación entre la estancia hospitalaria, funcionalidad alcanzada y el tiempo hasta el inicio del tratamiento fisioterapéutico en los pacientes admitidos a un servicio de cirugía de un hospital de alta complejidad. Materiales y métodos Estudio observacional, analítico de corte transversal. Se incluyeron 279 personas (124 mujeres). Los días de retraso en el inicio de fisioterapia, los días cama, la estancia hospitalaria prolongada (percentil 75 de días cama), y el nivel funcional fueron registrados para investigar la influencia del retraso en el inicio de atención fisioterapéutica sobre estas variables. Resultados El número de días de retraso de atención fisioterapéutica estuvo altamente relacionado con el número de días cama (r2 = 0,74, p < 0,05). A su vez, un retraso mayor a cinco días en el inicio de atención fisioterapéutica se asocia al desarrollo de estancias hospitalarias prolongadas (p < 0,05). Sin embargo, la fisioterapia tuvo efectos similares sobre el nivel funcional, aun con retraso en su inicio (p > 0,05). Conclusiones Retrasos en el inicio de atención fisioterapéutica se asociaron con estancias hospitalarias prolongadas en pacientes admitidos a un servicio de cirugía de un hospital de alta complejidad. Futuros estudios deberían investigar los factores asociados a este fenómeno (AU)

Objective To evaluate the association between hospital stay, functional status and physical therapy delay (PT delay) in patients admitted to a surgery unit of a high complexity hospital. Materials and methods Observational, analytic and cross-sectional study. We included 279 patients (124 women). Days of PT delay (calculated as the difference between hospital admission and start of PT), days of bed rest, prolonged hospital stay (75th percentile of bed rest days), and functional status were registered to investigate the influence of PT delay on these variables. Results The number of days of PT delay was strongly associated with the number of bed rest days (r2 = 0.74, p < 0.05). Moreover, a PT delay of five days or more was associated with extended lengths of stay in our sample (p < 0.05). However, physical therapy had similar effects on functional status, even when there were PT delays (p > 0.05). Conclusions PT delay is associated with extended length of stay in patients admitted to a surgery unit of a high complexity hospital. Future studies should investigate the associated factors that could explain the occurrence of PT delays in surgical patients (AU)

Fístula utero-yeyunal secundaria a migración de dispositivo intrauterino: reporte de un caso / Utero-jejunal fistula secondary to intrauterine device migration: a case report

RESUMEN El dispositivo intrauterino (DIU) es un método anticonceptivo muy popular, eficaz y seguro. Aunque posee complicaciones bien descritas como es la migración, la que puede ser a otros órganos dentro de la cavidad peritoneal. La fístula uteroyeyunal es un evento clínico poco frecuente, pero de gran repercusión si no es diagnosticada y tratada. Se presenta el caso de una paciente usuaria de DIU, el que migra a cavidad abdominal, con posterior formación de fístula uteroyeyunal.

ABSTRACT The intrauterine device is a popular, efficient and safe contraceptive. Although it has some well described complications, such as migration, which may be to the different organs inside of the peritoneal cavity. The uterus-jejunal fistula is a rare clinical event, but with great repercussion if it is not well assessed and treated properly. We present the clinical case of a patient with a migrated intrauterine device and a fistula uterus-jejunal formation.

Dicke and Fano-Andreev reflections in a triple quantum-dot system.

This article studies quantum interference effects and their influence on the electronic transport through a parallel triple quantum-dot system coupled to normal and superconducting leads in the linear response and non-equilibrium regime. We model the system by a triple impurity Anderson Hamiltonian including the Coulomb intra-dot correlations in all quantum-dots. Using the non-equilibrium Green's function formalism, we calculate the Andreev conductance and the transmittance for energies within the superconductor gap. Our results show that the Andreev reflection spectra, both in the presence and absence of Coulomb interaction, reveal Fano and Dicke-like resonances in analogy to the Fano and Dicke effects in atomic physics. As one of the main results, we obtain that the charge shows abrupt changes due to the Dicke effect.

[Length of hospital stay and functional status in patients with delayed start of physical therapy]. / Estancia hospitalaria y funcionalidad en pacientes con retraso en el inicio de tratamiento de fisioterapia.

OBJECTIVE: To evaluate the association between hospital stay, functional status and physical therapy delay (PT delay) in patients admitted to a surgery unit of a high complexity hospital. MATERIALS AND METHODS: Observational, analytic and cross-sectional study. We included 279 patients (124 women). Days of PT delay (calculated as the difference between hospital admission and start of PT), days of bed rest, prolonged hospital stay (75th percentile of bed rest days), and functional status were registered to investigate the influence of PT delay on these variables. RESULTS: The number of days of PT delay was strongly associated with the number of bed rest days (r2 = 0.74, p < 0.05). Moreover, a PT delay of five days or more was associated with extended lengths of stay in our sample (p < 0.05). However, physical therapy had similar effects on functional status, even when there were PT delays (p > 0.05). CONCLUSIONS: PT delay is associated with extended length of stay in patients admitted to a surgery unit of a high complexity hospital. Future studies should investigate the associated factors that could explain the occurrence of PT delays in surgical patients.

Correction to: Nuclear medicine services after COVID-19: gearing up back to normality.

The authors P. Orellana and N. El-Haj were inadvertently deleted in the original paper.

Tuning the thermoelectric response of silicene nanoribbons with vacancies.

In this work, we present a thorough study of the thermoelectric properties of silicene nanoribbons in the presence of a random distribution of atomic vacancies. By using a linear approach within the Landauer formalism, we calculate phonon and electron thermal conductances, the electric conductance, the Seebeck coefficient and the figure of merit of the nanoribbons. We found a sizable reduction of the phonon thermal conductance as a function of the vacancy concentration over a wide range of temperature. At the same time, the electric properties are not severely deteriorated, leading to an overall remarkable thermoelectric efficiency. We conclude that the incorporation of vacancies paves the way for designing better and more efficient nanoscale thermoelectric devices.

Quasistatic and quantum-adiabatic Otto engine for a two-dimensional material: The case of a graphene quantum dot.

In this work, we study the performance of a quasistatic and quantum-adiabatic magnetic Otto cycles with a working substance composed of a single graphene quantum dot modeled by the continuum approach with the use of the zigzag boundary condition. Modulating an external or perpendicular magnetic field, in the quasistatic approach, we found a constant behavior in the total work extracted that is not present in the quantum-adiabatic formulation. We find that, in the quasistatic approach, the engine yielded a greater performance in terms of total work extracted and efficiency as compared with its quantum-adiabatic counterpart. In the quasistatic case, this is due to the working substance being in thermal equilibrium at each point of the cycle, maximizing the energy extracted in the adiabatic strokes.

Impact of International Atomic Energy Agency support to the development of nuclear cardiology in low-and-middle-income countries: Case of Latin America and the Caribbean.

Cardiovascular diseases (CVDs) are the leading cause of death in Latin America and the Caribbean (LAC) region as well as worldwide. Lifestyle, nutritional habits and the upsurge of obesity have contributed to the increase in the prevalence of CVDs in the region. The role of nuclear cardiology in the management of patients with CVDs is well established. Particularly, myocardial perfusion imaging is widely used in LAC countries and has been increasingly integrated into the healthcare systems in the region for the diagnosis of coronary artery disease, risk stratification and to guide patient management. In its role to support countries around the world to address their health needs through the peaceful applications of nuclear techniques, the International Atomic Energy Agency (IAEA) has provided assistance to the LAC region for the establishment and strengthening of the nuclear cardiology practice. To that extent, the IAEA provides support in building capacities of multidisciplinary teams of professionals, the provision of medical equipment and the promotion of communication and exchange of knowledge among the different stakeholders. In addition, the IAEA encourages the participation of nuclear medicine centers in international multi-center research studies. In this paper, we present some of the projects through which the IAEA has supported the LAC region, including regional technical cooperation projects and coordinated research projects related to cardiology within the current multimodality approach to cardiac imaging.

Tunable Spin-Polarized Edge Currents in Proximitized Transition Metal Dichalcogenides.

We explore proximity-induced ferromagnetism on transition metal dichalcogenides (TMDs), focusing on molybdenum ditelluride ribbons with zigzag edges, deposited on ferromagnetic europium oxide (EuO). A tight-binding model incorporates exchange and Rashba fields induced by proximity to EuO or similar substrates. For in-gap Fermi levels, electronic modes in the nanoribbon are localized along the edges, acting as one-dimensional (1D) conducting channels with tunable spin-polarized currents. TMDs on magnetic substrates can become very useful in spintronics, providing versatile platforms to study the proximity effects and electronic interactions in complex 1D systems.

Bound states in the continuum poisoned by Majorana fermions.

In this work, we study the bound states in the continuum (BICs) in a system formed by a triple quantum dot array embedded between two one-dimensional topological superconductors (TSCs), both hosting Majorana bound states (MBSs) at their ends. The results show the formation of BICs with topological characteristics due to the presence of MBSs. This is a consequence of the interplay between the BIC arising from quantum dots states by means of energy level symmetry breaking through gate voltages, and MBSs leaked into the quantum dots. The BIC is not observed when both TSCs are in long wire limit, i.e. for vanishing inter MBSs coupling, while it projects into the electronic transmission whenever the inter MBSs couplings are away from zero, regardless if they have different strength and/or the phase difference between both TSCs. We study the behavior of BICs poisoned by MBSs as a function of the parameters that are controlling the system. We believe our findings could be useful to implement a protection tool for BICs using MBSs based on tunable gate voltages.

Histological and Immunological Description of the Leishmanin Skin Test in Ibizan Hounds.

The leishmanin skin test (LST), a delayed-type hypersensitivity (DTH) reaction to Leishmania infantum, can specifically identify dogs that have made a cell-mediated immune response to L. infantum infection. The Ibizan hound appears to be more resistant to L. infantum infection than other breeds of dog. The aim of this study was to describe the histological and immunohistochemical changes induced by the LST in Ibizan hounds living in an area highly endemic for leishmaniosis. The majority of dogs were apparently healthy, lacked serum antibody to L. infantum and blood parasitaemia, but had marked specific interferon gamma production after in-vitro blood stimulation with L. infantum. Leishmanin (3 × 108 killed promastigotes of L. infantum/ml) was injected intradermally and biopsy samples were obtained from a positive reaction at 72 h from nine Ibizan hounds. A moderate to intense, perivascular to interstitial dermatitis and panniculitis characterized the inflammatory response at the injection site. In addition, three samples had diffuse inflammation in the deep dermis and panniculus. Oedema and necrosis were present in the deep dermis and panniculus. Congestion and haemorrhage were observed in five biopsies. T lymphocytes (CD3+) and large mononuclear cells (lysozyme-) were the most prevalent cells. CD3+ cells were significantly more numerous than CD20+ B cells and lysozyme+ cells. B cells were sparsely distributed, especially in the deep dermis and panniculus. Rare neutrophils and macrophages (lysozyme+) were observed with few eosinophils. Toll-like receptor (TLR)-2 protein was expressed in large mononuclear cells mainly located in the superficial dermis. Leishmania immunohistochemistry was negative and quantitative polymerase chain reaction was positive in all cases. The intradermal injection of killed L. infantum promastigotes in Ibizan hounds causes similar histological and immunohistochemical findings to those described for human subjects and are indicative of a DTH response. Moreover, TLR2 protein is expressed in inflammatory cells similar to findings in clinically affected skin biopsy samples.

Detecting coupling of Majorana bound states with an Aharonov-Bohm interferometer.

We study the transport properties of an interferometer composed by a quantum dot (QD) coupled with two normal leads and two one-dimensional topological superconductor nanowires (TNWs) hosting Majorana bound states (MBS) at their ends. The geometry considered is such that one TNW has both ends connected with the QD, forming an Aharonov-Bohm (AB) interferometer threaded by an external magnetic flux, while the other TNW is placed near the interferometer TNW. This geometry can alternatively be seen as a long wire contacted across a local defect, with possible coupling between independent-MBS. We use the Green's function formalism to calculate the conductance across normal current leads on the QD. We find that the conductance exhibits a half-quantum value regardless of the AB phase and location of the dot energy level, whenever the interferometer configuration interacts with the neighboring TNW. These findings suggest that such a geometry could be used for a sensitive detection of MBS interactions across TNWs, exploiting the high sensitivity of conductance to the AB phase in the interferometer.

Allele frequencies in Azuay Population in Ecuador.

One hundred and eighty-two samples of unrelated people who requested the paternity test at the Molecular Biology and Genetics Laboratory of the Catholic University of Cuenca-Ecuador in the province of Azuay were studied, except for the D1S1656 (180 samples) and SE33 (89 samples) markers. The STRs D22S1045, D3S1358, VWA, D16S539, D2S1338, D8S1179, D21S11, D18S51, D19S433, TH01, FGA, D1S1656, D12S391, D10S1248, D2S441, and SE33 were typed from blood samples, amplifying the DNA by polymerase chain reactions and electrophoresis. The allele frequencies were estimated by simple counting and the impartial heterozygosity was also calculated. The Hardy-Weinberg equilibrium theory was studied. In the results obtained with the analyzed markers, the largest number of alleles can be observed in the markers with the highest polymorphic information content (PIC): D21S11, D16S539, D2S1338, D19S433, D18S51, FGA, D1S1656, and D12S391. In addition, SE33 was analyzed in certain samples, showing as result a high PIC, in fact, the highest one because of its great polymorphisc characteristic. Likewise, these markers are the ones providing the highest probability of discrimination and the lowest probability of coincidence.

Fano-Andreev effect in a T-shape double quantum dot in the Kondo regime.

In the present work, we investigate the electronic transport through a T-shape double quantum dot system coupled to two normal leads and to one superconducting lead. We explore the interplay between Kondo and Andreev states due to proximity effects. We find that Kondo resonance is modified by the Andreev bound states, which manifest through Fano antiresonances in the local density of states of the embedded quantum dot and normal transmission. This means that there is a correlation between Andreev bound states and Fano resonances that is robust under the influence of high electronic correlation. We have also found that the dominant couplings at the quantum dots are characterized by a crossover region that defines the range where the Fano-Kondo and the Andreev-Kondo effect prevail in each quantum dot. Likewise, we find that the interaction between Kondo and Andreev bound states has a notable influence on the Andreev transport.